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Volume 23, Issue 5 (September 2021) 23, 527–531; 10.4103/aja.aja_11_21

Analysis of the social and clinical factors affecting the age of children when receiving surgery for hypospadias: a retrospective study of 1611 cases in a single center

Zhi-Cheng Zhang1,2,3,4,5, Xing Liu1,2,3,4,5,6, Hong-Song Chen1,5, Yan Shi1,2,3,4,5, Tao Lin1,2,3,4,5,6, Da-Wei He1,2,3,4,5,6, Guang-Hui Wei1,2,3,4,5,6, Ye-Tao Luo5

1 Department of Urology, Chongqing Medical University Affiliated Children's Hospital, Chongqing 400010, China
2 Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400010, China
3 National Clinical Research Center for Child Health and Disorders, Chongqing 400010, China
4 China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400010, China
5 Children's Hospital of Chongqing Medical University, Chongqing 400010, China
6 Chongqing Key Laboratory of Pediatrics, Chongqing 400010, China

Correspondence: Dr. X Liu (dr.liux0217@gmail.com)

Date of Submission 09-Jun-2020 Date of Acceptance 31-Dec-2020 Date of Web Publication 12-Mar-2021


We aimed to explore the associations between the age at which children undergo surgery for hypospadias and a range of social and clinical factors in a single center. Our aim was to promote the early surgical treatment of children with hypospadias. For a 6-year period, social and clinical data were collected from all children undergoing surgery to repair hypospadias in Children's Hospital of Chongqing Medical University (Chongqing, China), located in southwest of China. We analyzed the correlations between age at surgery and a range of social and clinical factors. A total of 1611 eligible cases were recruited, with a mean age of 54.3 months and a median age of 42 months: 234 cases (14.5%) were classified into a “timely operation” group, 419 (26.0%) cases into a “subtimely operation” group, and 958 (59.5%) cases into a “delayed operation” group. According to multivariate regression analyses, the higher the regional economic level, the closer the urethral opening to the perineum, and the higher the educational level of the guardians was, the younger the children were when they underwent the initial surgery for hypospadias; this was also the case for families without other children. Our subgroup analysis showed that the primary educational level of the guardians was a risk factor for subtimely surgery in their children (odds ratio [OR] = 1.52, 95% confidence interval [CI]: 1.08–2.15, P < 0.05). A lower regional economic level (OR = 1.87, 95% CI: 1.26–2.78, P < 0.01), a lower educational level of the guardians (OR = 3.84, 95% CI: 2.31–6.41, P < 0.01), and an anterior-segment urethral opening (OR1 [vs middle hypospadias] = 2.07, 95% CI: 1.42–3.03; OR2 [vs posterior hypospadias] = 2.63, 95% CI: 1.75–3.95; P < 0.01) were all risk factors for delayed surgery in children.

Keywords: age; children; hypospadias; surgery

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